Organ Donors and Related Matters Bill

Tēnā koe, Mr Speaker. I’d just like to begin by recapping where I ended off previously, and I was talking to a submission that we received in the Health Committee, and it was from a group of students in Auckland, Macleans College. They were taking on this as a project for their level 3 social studies class. So they made some great recommendations to the select committee. In fact, they recommended that the committee consider substantial increases in funding towards the New Zealand Blood Service that will be dedicated to this new planned organ donation agency, and suggested that this funding would idealistically be specifically used towards public messaging around live and deceased organ donations in Aotearoa New Zealand. That’s a really great suggestion, because to get the awareness out there, to get those donation rates up, public messaging is a great way to go about that. They’ve also suggested this should include funding for further research and development in the area of organ donation. So it was good to have the submission from those students, and I’d like to make note of all those who submitted. It was great to receive their contributions to this bill.

New Zealand First, we support the Organ Donors and Related Matters Bill. It contains a number of improvements to our organ donation programme that really are long overdue, and I think we’d all agree with that in this House. You know, it actually will help to meet the needs of living people who donate an organ, and also for the families of deceased people who donate. It folds neatly and cost-effectively into the New Zealand Blood Service, which actually has the experience as well as the ability to manage the programme that will be coming to them, and to promote the service, ultimately, to get those donor numbers up. What is proposed is really sensible and it’s not unnecessarily coercive to get those numbers up.

This bill also will provide for those organ donors who are not currently eligible for compensation but who clearly deserve it. So those that need to take time to recover after they’ve made an organ donation, they will have that time and that compensation to go with it. So, for example, they will be eligible for earning compensations for 12 weeks immediately after surgery. Now, if they happen to need extra time, then they will be given that. So it’s important that we compensate them for that. Maybe they return to work inside that 12-week period and need to take time off again because of the effects of surgery—then they will receive adequate compensation for their time.

You know, we actually can’t pass a law to make people donate their organs. There’s no stick that can be used in this, but very carefully allocated carrots, and this bill will set about to do that. New Zealand First continues to support this bill. Thank you, Madam Speaker.

Thank you very much, Madam Speaker. It’s a shame that after an eight-minute speech, Jenny Marcroft, the member for New Zealand First, doesn’t actually appear to know what the bill does, because the law already states that those who donate—

💬 Hon Clare Curran: So arrogant.

Well, it’s just a statement of fact. I mean, she doesn’t know what the bill does. It is already the law that those who donate organs are entitled to compensation. The last Parliament passed that piece of legislation. In fact, it was a member’s bill in my name—which is why I’m so annoyed about it—that did that. So that is already the law, and it’s a shame that we have had an eight-minute speech now that, essentially, purports to enact a very useful change I agree with, which is to give compensation for those who are organ donors. Ms Marcroft is correct that it makes some useful, small clarificatory changes around that regime. That’s in Part 2 of the bill, to amend the Compensation for Live Organ Donors Act 2016, which amends the interpretation of “usual hours” in the bill, something that was missed when we did the initial bill, and so that’s a useful change.

The other thing that the bill does, which we agree with on this side of the House, is to give the New Zealand Blood and Organ Service, essentially, oversight over organ donation and the transplantation system. I’ve got to say, this is something that has been in the works for many years, and it’s frustrating that it has taken until two years into this Government’s time in office that we have had the simple—[Interruption] Well, members opposite complain, but I mean, frankly, it’s not like a lot of useful stuff’s been done in the meantime. I mean, we’ve legislated for fees-free tertiary education—a public policy disaster. We’ve legislated for all sorts of other stupid ideas, and a very sensible change that the Government could have done months ago has taken until now to get on to the Order Paper. In fact, I know for a fact that the Minister of Health, David Clark, was actually looking at an omnibus bill around organ donation 18 months ago, and my question to members opposite is: where is that bill? Because this is a small, 20-clause bill—a small bill—and we know for a fact that there’s an omnibus bill in the works. Well, where is it?

Of course, the other thing to note is: where is the funding? Because, yep, we’re going to get the New Zealand Blood Service in charge of organ donation and transplantation. That’s all well and good, but I know for a fact that there is no increased funding for the New Zealand Blood Service out there to actually implement the changes that Parliament wants them to do. So where is the extra money? We’re not talking about a huge amount of money here; we’re talking about a few million dollars, and it just speaks to the total incompetence of the Minister of Health, David Clark, that he can’t extract a few extra million from the Minister of Finance in order to implement what is a very, very sensible piece of legislation.

I care deeply about this issue, because organ donation in New Zealand is something that we have neglected for too long. Organ donors are heroes. Frankly, the way in which they are encouraged in New Zealand could be a lot better. This is a sensible minor bill, but we need to do far more. We need to fund the New Zealand Blood and Organ Service properly. We need to equip them with the skills and the capability to encourage organ donation. But we do support the bill and I commend it to the House.

Thank you, Madam Speaker. It’s always a pleasure to follow Chris Bishop in any debate, actually. But I wanted to start, because it did sort of rove into the partisan, with that last speech. I always find it amusing in the House when we’re sort of caught furiously agreeing with each other about something, and this appears to be one of those cases where we’ve got bipartisan support. I actually do want to acknowledge Mr Bishop for his original member’s bill, which we supported back in the previous Parliament, which we thought was excellent and, of course, has laid the foundation for this. His quibbles about timeliness of the amendments aside, I think that that was a good piece of work and I’m glad that we are in a position to be able to build with it now.

I note, as Mr Bishop said in his speech, that it is a small bill, a 20-clause bill. It’s not terribly complex. That in some ways was reflected in the low number of submissions. There were only 16 written submissions and, I think, five verbal submissions that the select committee had to hear. Not a great deal of amendments. Again, I think that suggests that we got the general direction of the legislation right and that people agree with it. It is generally the more contentious stuff, obviously, where you get huge numbers of submissions and people take that as an opportunity to try and lobby for a position. So I have some confidence that actually the low number of submissions isn’t a reflection of people’s disinterest but a sense that we’ve got it right and people are pretty happy with the direction of travel. So I am really pleased that we are in a position to be able to forward the legislation ahead.

I just wanted to reflect on a couple of the core pieces which Mr Bishop referred to, the first being the nature of, you know, trying to drive up the number of donors that we’ve got in the country by making sure that the compensatory regime that we’ve got in place actually encourages people to change behaviour, to become organ donors, or at the very least doesn’t stop them from doing that if they’re already doing it.

I just want to reference at this point, and this may be something that we want to examine later on, that in Europe, in the 27 countries in Europe, roughly half of the countries there have organ donation rates of about 25 percent and the other have organ donation rates of about 75 percent. If you try and work out which are the countries that have got low rates versus which countries have got high rates of organ donation, they are scattered east to west, north to south, high-income countries, low-income countries, different regulatory environments and so on. They have very little in common except for this: the countries that have got high donation rates of about 75 percent have opt-out regimes, and those that have low rates, about 25 percent, have opt-in regimes. That is the only difference between the two sets of countries in terms of organ donor rates that they have in the participation rates. So I think it would be worthwhile—and, obviously, it’s not within the scope in this, but I do suggest that it is an area that this Parliament should turn its attention to—the idea that we might actually want to consider amending this bill again in the future to encourage donation rates by making it an opt-out regime rather than opt-in regime as it is.

Having said that, what we’re doing here by changing the compensatory regime and setting up a national agency which is required to have a nationwide strategy—and if I just may suggest also, it was fantastic to hear Mr Bishop arguing for more health spending and greater calls on the Budget. It is completely inconsistent with his party’s requirements for lower taxation rates, nevertheless, but I think it was good to hear him suggesting and putting his shoulder to the wheel for this year’s Budget. But in doing these things, changing the compensation, setting up this national agency, it does provide a very good foundation for the future. And as that new agency does turn its head to its national strategy, perhaps one of the things that they may want to consider is whether we want to move towards an opt-out regime, because the evidence suggests that that would lead to significantly higher rates of organ donation in New Zealand.

Having said all of that, we find no fault with the work that the select committee have done with any of the submissions. We think it’s a good bill and I commend it to the House.

It’s a pleasure to rise in support of this very important bill, the Organ Donors and Related Matters Bill. I just want to touch on the work in the Health Committee—this is a second reading, of course—and talk about some of the amendments proposed and also some of what we heard from the submitters as well as what was canvassed in the House. There were only 14 submissions and five were heard orally. It is a small technical bill, but I must say it’s through the power of the select committee process and submitters getting involved that some very real amendments were made through this process, and it just goes to show that you don’t need thousands of submissions.

In one case, for clause 5 the intent of the bill was to not allow anyone living outside of New Zealand to be able to claim compensation for organ donation. But through what was advised through a submitter, it worked out that actually the wording would have allowed that. So the change to clause 5 actually closed down that provision and only allowed for the intent of the bill, which was New Zealand residents who might be donating an organ through a trans-Tasman programme to Australia and, quite rightly, New Zealand residents would get compensation for that.

There was also an amendment to clause 11, which from the submission—it is part of regulations, Order in Council, that there’ll be the required organ donor programmes to be part of this bill. But we do have one donor programme already, the trans-Tasman—I think it’s the liver or kidney programme. Here it is: the New Zealand Paired Kidney Exchange Program, which is already well established. So this will be the first programme that will actually be covered by this bill and will be implemented in the bill. Also retrospectively, anyone who is in this programme now, before the bill gets its Royal assent, will be able to receive compensation retrospectively.

There was also a lot of discussion about ensuring that this bill is well funded. I think it’s very well-canvassed in the House that we need to increase our rate of organ transplants. Unfortunately, this bill won’t deliver that. It really is up to a Government to increase funding for public awareness and education. So I would encourage the Government of the day to do that.

Also, there was a call for the wider scope of compensation for donors, whether that be travel or further medical costs and accommodation costs. So what the advice was that we got back from the advisers was there is already an ability to get this covered, and we would encourage people to do that. So, look, with a short call, I think this bill needs to be passed tonight. I commend the bill to the House.

The next call is a split call. I call Anahila Kanongata’a-Suisuiki.

Thank you, Te Mana Whakawā. It’s a privilege to stand here to make a contribution to the second reading of the Organ Donors and Related Matters Bill. I know the previous two speakers spoke about what this Government should do, but I really think this bill fits in with the Government’s wider plan to fix New Zealand’s health system after nine long years of neglect.

💬 Hon Members: What’s that?

Anyway, let me get back to this bill—nine long years of neglect, if you didn’t hear me.

Right, let me get back to this bill. I was present in the House when the Minister spoke about how it would make it easier for Pacific and Māori to have conversations with their family about organ donors. As a Tongan and as a Pacific person living in New Zealand, the most sacred part of a Tongan’s life is birth and death. At death, the body is so sacred that when you’re talking about organ donation almost near death, that conversation usually doesn’t end up being a gift of organ donation.

But live donors—I myself am a donor, but I haven’t had that conversation with my family. But in terms of an approach to make it easier for live donors, in terms of a Tongan person, I agree with this bill. In terms of Part 1, making it easier for New Zealanders to provide live donations of organs, I actually agree with that perspective in terms of providing live donors and support for that to happen.

We support this bill because it makes it, as I said before, easier for organ donation. I support the increased compensation that the bill provides for live organ donors and also want to acknowledge the work of the New Zealand Blood Service. What this bill does is it actually extends the work of New Zealand Blood Service. It changes the name of New Zealand Blood Service to New Zealand Blood and Organ Service. This reflects the additional statutory functions that will create not a new statutory entity, but it actually changes the name of the New Zealand Blood Service to New Zealand Blood and Organ Service. The New Zealand Blood and Organ Service will be the same organisation as the New Zealand Blood Service.

I just want to reiterate in terms of making it easier to donate organs. As a Tongan New Zealander, I want to again repeat the fact that at death, the tūpāpaku, or the deceased, is sacred to the family. However, alive donations should be a focus in terms of the work of the new-named Blood Service—like I’ve spoken to before about the New Zealand Blood and Organ Service—the focus on how you can culturally, appropriately respond to the services of New Zealanders.

In terms of that culture, that’s why I keep making the point that birth and death are sacred to Tongans, but live donations in between that—we belong to our families and we can provide that service. When we talk about service in terms of providing health services anywhere in New Zealand, the people who are often spoken to in equality of service provided, often the two populations in New Zealand that come after that are Māori and Pacific people.

If we approached organ donation from the perspective of culturally appropriate education and conversation with these two sets of populations, I think the outcome would be different. So I want to commend the work of the select committee, thank the submitters, and also the work of the New Zealand Blood Service. I want to commend their work and their new service that they’re going to provide. I commend this bill to the House. Kia ora.

The second five-minute call—the Hon Michael Woodhouse.

Thank you, Madam Speaker. It seems that there isn’t a speech from a Labour member that is complete unless it uses the words “nine years of neglect”. We heard that twice from the previous speaker, Anahila Kanongata’a-Suisuiki. I found that rather uncharitable on a bill where there is widespread bipartisan support and a bill that achieved a great deal when it was firstly written by me and then taken through the member’s bill stage by Chris Bishop and improved significantly by him, and it had an immediate positive effect of a 500 percent increase in the number of live organ donations as a consequence of this.

We’re not saying that that was a bad bill, but it can be improved, and so the previous Minister, Dr Coleman, actually, in reviewing the organ donation strategy, made the very recommendations that this Government has picked up and carried on. So I’m not going to be so uncharitable as to say that it’s only the most ardent Labour supporter that even believes the nonsense about nine years of neglect, but I will say this, particularly about Mr Shaw’s contribution in respect of opt in and opt out. That was a discussion that was held by the submitters to the Health Committee and, indeed, it was acknowledged that those issues were outside of the scope of this bill, but it is clearly something that the Government could consider and, with the right public consultation, I think we could support.

The other issue was the matter of advanced directives—the fact that there were a number of submitters, one of whom I know very well, who believes that the Human Tissue Act already provides for the person’s wishes to prevail after the event of their brain death and therefore that the quite sensitive issue about family veto can actually be circumvented if the Human Tissue Act was interpreted in the way that he, an eminent lawyer, believed was in place. But, again, it was outside of the scope of this bill.

The point I’m making is that there are actually a number of very good initiatives that I think we can continue to pursue in order to improve the live organ donation rate and deceased organ donation rates, because we do considerably lag behind. Nevertheless, thanks to the improvements from the select committee and the submitters—I want to thank them for that—we’ve got a good bill in a better shape, and I think we’re going to see a great deal more opportunities for live organ donation, particularly with the trans-Tasman arrangements that have been put in place. I’ll leave that there. There are some other technical matters that I can talk about in the committee of the whole House, but I won’t slow this process down.

Thank you, Madam Speaker. With a very short amount of time, I take great pleasure in rising to talk to the Organ Donors and Related Matters Bill. I was a member on the very hard-working Health Committee at the time that the bill was introduced, and I spoke on the first reading. I then moved from the select committee, but I did manage to hear some of the submissions. In fact, we had 16 written and five verbal submissions, so I did sit for some time hearing this bill.

I’d like to thank those people who did take the time to make the submissions for what they contributed. We had some small tweaks that happened, and then I came off the select committee at that point. I’m really pleased that our Minister David Clark saw fit to move this bill with its origins as a member’s bill, as we’ve heard in this House, into the legislative programme.

In my first speech, I talked of Wairangi Te Rupe, who is my daughter’s sister by another mother. So Wairangi Te Rupe at eight weeks old was diagnosed with biliary atresia, which is life-ending, essentially. She was able to get an organ—a liver. She’s now in her double digits and is living her best life and has been able to survive because of that. That liver, as I understand, was gifted to three people.

Debate interrupted.

The House adjourned at 10 p.m.